Measuring Resilient Aging in Different Populations of Older Adults

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Transcript of Measuring Resilient Aging in Different Populations of Older Adults

Resilient Aging in Different PopulationsCross-National Comparisonsand ResilienceMany older adults do wellSuccessfulAgingBiomedical ModelHealthy AgingDifferentperspectivesThe traditional aging research paradigm is missingimportant informationResilienceAdverseEventResilienceAdjustmentSystem(Older Adult)Protective Factors"The process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and ‘bouncing back’ in the face of adversity”.(Windle, 2011)DevelopingDevelopedMigrationMixedEpidemiological RegimeLower SESCultureHigher SESCultureAdvanced StageEpidemiologicalTransitionMeasuring ResilienceConceptual FrameworkDatasets Usedhttp://hrsonline.isr.umich.edu/Health and RetirementStudy (HRS)http://www.mhasweb.org/Mexican Health and AgingStudy (MHAS)SimilaritiesDifferencesProspective Nationally Representative Longitudinal Study of adults 50 years and olderCover health status, cognitive status, employment status, job history, family structure, transfers, housing conditionsBoth include some anthropometric measuresHRS started in 1992 and is still collecting data every 2 years; MHAS started in 2001, had a follow-up interview in 2003 and is now in the field collecting new data.HRS oversampled African Americans, Hispanics and residents in Florida; MHAS oversampled high migration states.Weights in HRS are post-stratified to the March CPS according to birth cohort, gender and race/ethnicity; MHAS weights were stratified based on birth cohort, household composition and place of residence.The StudiesResults of Cross-NationalComparison on ResilienceDomains and variablesHealthHealth ChangeHypertensionDiabetesLung DiseaseStrokeArthritisWeight LossHospitalizationPainCancerFunctionADLDisabilityMobilityDisabilityIADLDisabilityMentalCognitive ScoreDepressive SymptomsSocialNo VolunteerWorkReligion notImportantNo FriendsinNeighborhoodNo one toCount onThree Adverse EventsValidationAdverse Event PredictionDomain CorrelationComponent ReliabilityWHO Healthy AgingStrategySupportive EnvironmentsHealth and long-term care systemsStrengthen evidence base and researchHealthy Aging over the life courseFalls preventionVaccination and infection preventionPhysical activitySupport to informal care-givingGeriatric and gerontological capacity buildingPriority InterventionsChangeBaseline StatusDescriptive DataMHASWorse healthPainHRS5/6 medical conditionsHospitalizationHealthHRSMore ADL disabilityMHASMore IADL disabilityMore mobility disabilityFunctionMHASLess volunteersHRSLess religiousLess friends close byLess people to count onSocialMHASLower cognitive scoreHRSMore depressive symptomsMentalPrevalence at baseline of ComponentsTranslating Findings to Patient CareFallsHeart AttackCovariablesDemographic CharacteristicsSocioeconomic StatusChildhood HealthHealth BehaviorsSRHTiming of EventType of EventBaseline StatusMHAS Sample(n=3,606)With Event(n=1,275)Without Event(n=2,331)HRS Sample(n=6,567)With Event(n=1,729)Without Event(n=4,838)Sample Size from Both StudiesPredictors of Resiliencein Both StudiesResilience is a useful concept to understand how older adults cope with adverse events.Resilience is highly prevalent in both developing and developed countries and should therefore become a more important focus of aging research.Analyzing older adults with a comprehensive approach enhances our ability to understand older adult health.ConclusionsConceptual Model of ResilienceSupportive environmentsCross-national comparisons allow us to better understand how populations in different contexts experience distinct aging paths.Cross-national comparisons provide useful information on how older adult health will change as developing countries move through the different stages of the epidemiological transition. The life-course approach provides useful information to better understand mechanisms and pathways that determine health in older adults.Changing the aging research paradigm that mainly focuses on disease, disability and mortality will help us understand positive aspects of aging, allowing us to develop interventions to promote recovery and improve quality of life among older adults.